Self-monitoring and self-management of oral anti-coagulation therapy Essay

Self-monitoring and self-management of oral anti-coagulation therapy practice - Essay Example Today’s healthcare practice is changing rapidly and thus, provision of patient care and management is shifting from institutional-based management to home-based care where patients can test their status and manage the condition, especially for medical conditions that are not curable but only manageable such as diabetes. One of the testing and management practice being prompted and is gaining popularity in the healthcare sector is the Oral Anti-Coagulation Therapy Practice for patients (Ansell, et al., 2005). This paper concerns the designing of a plan aimed at changing our patients habit from that of going to the lab in hospitals and other healthcare facilities just to get their International Normalized Ratio (INR) testing done to getting these patients who have the capacity to learn how to use a home based testing device for INR instead of seeking lab based testing. The idea behind this concept is the fact that this process is fairly simple and if patients are well educated, they can easily do the test accurately and without any hustle (Baglin, et al., 2005). Besides, home based INR testing devices will be able to give results required in a very short while, actually immediately, just like it is the case for those diabetic patients who normally test for their daily levels of glucose. This is not the case when they seek lab based testing since the process takes 24 hours to get the results due to the large number of patients who might need the same service and the fact that in many instances, the medical practitioners do not match the number of patients.... It is a medical fact that any change in the health, lifestyle or drugs in a patient’s life could quickly interfere and alter the oral anticoagulant’s effectiveness in managing such conditions. What makes it even worse is the fact that each patient reacts differently to these drugs thus the need for regular monitoring of the therapy. However, I tend to think, based on reviews done, that there are strategies that could be used to improve the situation and have these patients self-monitor and self-manage their condition. The evidence based model for change has been derived from a thorough theoretical and research literature that is related to various research utilizations, change theory and the current evidence-based practice within the field (Rosswurm, 1992). This model has a guideline to medical practitioners for changing the normal practice to evidence based practice. Various stages have been proposed for effective implementation of this model. These start with step one where the need for change in the healthcare practice is done. In regard to this, the carrying out of an Oral Anti-Coagulation Therapy at home has been identified as the need for change where patients would have to test and manage their condition at home as is opposed to seeking lab testing. The need is therefore to help patients test their condition at home to establish their INR level within the required range. The reason for doing this comes from the fact that patients have been dissatisfied with the current trend of lab based testing which takes longer to process. The quality of the data got will also be reliable since it will be fresh and immediately established for quick action to

Expository Prose Assignment Essay Example for Free

Expository Prose Assignment Essay 1.Ed Pilkington purpose for this article is to inform the audience that he wants to abolish the rule of execution because in this article, the U.S legal system made a fatal mistake by sentencing an innocent man to his death.   This article is in expository style because it has a thesis that explains what he is going to talk about and it has the proper structure of beginning, body and conclusion. Another reason is because the author is explaining his knowledge on what he believes on, which is informing his audience by sharing the trail of an innocent man. The thesis in this article is explicit. It is explicit because the author clearly states it in the article near the beginning. â€Å"It is now clear that a person was executed for a crime he did not commit, and his name –Carlos Deluna – is being shouted from the rooftops of the Columbia Human Rights Law Review.† This article is also considered in expository style because it includes methods of exposition. One of the methods that are being used is the short anecdote. This method is shown when the author explains a short flashback of the day of the murder and this evidences to the audience that there is proof that Carlos Deluna is innocent. â€Å"Carlos Deluna told the jury that on the day of the murder he’d run into Hernandez, who he’d known for the previous five years. The two men, who both lived in the Southern Texas town of Corpus Christi, stopped off at a bar. Hernandez went over to a gas station, the Shamrock, to buy something, and when he didn’t return Deluna went over to see what was going on.† Another method is used when the author contrast the trial of OJ Simpson with the Carlos trial. â€Å"This wasn’t the trial of OJ Simpson.† The author uses this method because he is trying to reach out to his audience by saying that this case has no real evidence that Carlos Deluna is the real criminal. While contrasting to the case of OJ Simpson where there was actually proof that OJ was the murderer. The third method of exposition that is used is the process of cause and effect. This example is shown when the author explains how the detectives failed to carry out important evidence like blood samples. The cause in this case would be the detectives not examining blood samples and the effect would be the death of an innocent man 2.The rhetorical situation in this case would be any American citizen that listens or reads about the news and the writer would be Ed Pilkington in New York Times. Ed Pilkington is grabbing the attention of American citizens by informing the citizens that a fatal mistake; made by the U.S legal system caused an innocent man to his death. This article is written for almost all Americans because Pilkington is sending a message to the citizens that they should be more aware of the U.S legal system from now on because miscarriages of justice might happen again. Another reason why this article is for all U.S citizens is because the structure of the article is not long and not too difficult to read. The structure of this article is simple and easy to understand. Pilkington made his paragraphs short but long enough to explain the article precisely. Meaning all Americans can read this article, not just intellectual geniuses. Lastly, the nature of the relationship between the author and the reader is American to another American. The reason for this is because Pilkington wants all Americans to hear about his article, not just specific amount of people. So Pilkington (an American) is explaining his story with other Americans. 3.The definition of style is a characteristic manner of expression, combining the idea that is being expressed with the individuality (the particular voice) of the author. Style includes such general qualities as diction, sentence structure and variety, imagery, rhythm, coherence, and emphasis. In this article the style the author uses is simple and understandable. The author uses some of the qualities that are mentioned in the definition. One of the qualities the author uses is diction. The diction in this piece of article is informal and easy to understand. The vocabulary is not difficult and it is easy to read so most Americans will be able to understand the entire article. Also another style quality that is used is the sentence structure. The sentence structure of this article is short but exact. Meaning it has the right amount of important information and since its short, most readers would not lose interest from it. 4.The relationship between the audiences is Ed Pilkington the author, to any American citizen. Ed Pilkington in this article seems to know his audience very well. He grabs the audience’s attention by using an easy type of style that can be understood by the general public, while still explaining the author’s opinion. The author not only grabs the audience’s attention, he expresses his purpose through out the whole article. The author’s purpose is to try to convince his audience that the capital punishment of execution should be abolished. Like I said before, the author uses a style that is effectively easy for the audience to understand the meaning of criminal and political matters. Even though the author’s style makes the article well written, the article seems to be less effective then effectual. The author explains the article by implying the meaning in one case. The author could have compared more articles on fatal mistakes from the U.S legal system because the trial occurred few years from now and as years go bye, the Government legal system has been improved. Furthermore, the article is effective because the author proves his thesis by describing how an innocent man was sentenced to death but the fact that the author used one example, makes it a risky decision to follow. So overall, the author proves his thesis by using the right type of style, but the concept of abolishing the lethal injection does not seem comprehensible with the proof of just one article.

Response to Reading Rohinton Mistrys A Fine Balance Essay -- A Fine B

Response to Reading Rohinton Mistry's A Fine Balance I chose to read Rohinton Mistry’s A Fine Balance, a story about four very different people living in India during a period of great civil unrest known as The State of Emergency. I found this book incredibly easy to get into because of the way Mistry writes. He seems to create the story around you, placing you in the setting as a viewer, involving you in the lives of the characters. Mistry clearly outlines the political and economic situation of India at the time, further emphasizing the plight of the main characters. The first thing I noticed about Mistry’s writing style is his incredible ability to make you feel like you’ve actually shifted to another country, another continent even. His descriptive ability allowed me to imagine so many little details in the book, the smell of the street, the loud, boisterous vendors screaming their slogans as pedestrians walk by. You really get to feel as if you are witnessing the events as they unfold. The first part of the book explained the story but then it promptly switched to brief histories of each of the main characters before introducing them to the main plot. Mistry gives you the diverse backgrounds of all the main characters, using his beautifully descriptive language to make even simple things brilliant. The story takes place in an â€Å"unnamed City by the Sea† somewhere in India, exploring the lives of four very different people. Mistry creates characters that come from a very different world than I’m used to, maki ng the story all the more interesting for me. Mistry included many cultural references in the story that I looked up so that I knew a little more about the basis of the story. Before I had read this novel I had no knowledge of the State of Emergency (having been born after it took place) so I found reading about it from the perspective of a person experiencing it, very informative. This first section of the novel displays the interaction of the characters quite differently form the interaction they eventually have. All the characters are stiff and formal with each other. It is not until the next section of the book that they start to warm up to each other. Reading Response Journal #2 The beginning of this section marks a change in the book as all the main characters are now living under one roof and their attitude... ...of writing impressive and elegant without being over the top. He takes you on a roller coaster of emotions throughout the novel, leading you from happiness to depression in the blink of an eye. This book taught me something I had already vaguely known, that the world can be a very cruel place. The problem was I had never truly imagined it this cruel and abusive. It broke my heart and completely re-enforced my plans as to what I’m doing after I finish university. I plan on working for th UN in underdeveloped countries, focussing on social interactions and medical services. The way Mistry wrote this book affected me deeply. I think the theme of this book was about the power of human perseverance and the ability of the downtrodden to always look for ward to the next day with optimism. The four characters in this novel face tremendous ordeals and yet they still manage to maintain a small amount of control over their lives. Mistry writes in such a way that you can see their vul nerability, but you can also see how mentally and physically strong they are. They find comfort in the small things we take for granted, and as such they truly show their faith in a society that is failing them.

Locke and Hobbes Essay

How does the founders’ view of power affect the framers’ reactions to John Locke? According to Locke, how does man enter the political society and what is the purpose of that society? What obligations does the government have in the civil society? What obligation does the individual have? How do Hobbes and Locke differ? Do you think Americans would agree with Locke? You may read the first paragraphs of the Declaration of Independence to assist you. What evidence do you have to support your view? The founders believed that the power of government should be limited, so it doesn’t trample on peoples’ natural rights. The framers thus wrote in guarantees that the government could not usurp individual freedoms. Locke believed that citizens gave their consent to the government so that society would operate freely and safely. Government should ensure equal opportunity and protection of political and property rights. The individual is obligated to participate in the political process, but abide by the government’s rules. Hobbes is more pessimistic about how violent the state of nature would be and is therefore willing to give the government more power than Locke is. Yes, Americans seem happy that the government has power, but individuals retain rights as well. Unlike many countries, the United States has never had a revolt against its government in the last 200 years (The Civil War was something very different.)

Customs and traditions in the USA Essay

Customs and traditions are important part of our culture, of our lives. Customs and traditions unite, build community. They provide identity. They tie us to our ancestors and heritage. They remind us of where we came from. Every country and every nation has it’s own traditions and customs. It’s very important to know traditions and customs of different people. It will help you to know more about the history and life of different nations and countries. Custom is a traditional and widely accepted way of behaving or doing something that is specific to a particular society, place, or time; a thing that one does habitually. Tradition is the transmission of customs or beliefs from generation to generation, or the fact of being passed on in this way; long-established custom or belief that has been passed on from one generation to another All countries have their social customs and peculiarities, and the US is no exception. The first group of custom which is worth speaking about is connected with meeting someone. When meeting someone for the first time, it is customary to shake hands, both for men and for women. Hugs are only exchanged between close friends. Kissing is not common. Among friends, it’s common for men to kiss ladies on one or both cheeks. Men don’t usually kiss or embrace each other. Americans usually introduce themselves by their first name and last name (such as â€Å"Hello, I’m John Smith†), or, if the setting is very casual, by their first name only (â€Å"Hi, I’m John†). The common response when someone is introduced to you is â€Å"Pleased to meet you.† Americans generally dislike formality or any sort of social deference due to age or position, and most quickly say ‘Please call me Rick (or Rita)’. To Americans, informality shows no lack of respect. Because of the rise of women’s liberation in America, women may be introduced with the title ‘Ms’ (pronounced ‘mizz’) and some women object to being addressed as ‘Miss’ or ‘Mrs’. In some social circles, women are introduced after their husbands, e.g. Mrs Chuck Whizzkid, in which case you shouldn’t address her as Chuck! Americans often reply ‘You’re Welcome’ or something similar when somebody thanks them, and they may think you’re impolite if you don’t do likewise. If someone asks ‘How are you?’, it’s usual to reply ‘Fine thanks’ and don’t complain even if you feel dreadful. Americans don’t have status or inherited titles (e.g. Sir or Lord) but it is necessary to defer to people with a professional title which has been earned. These include foreign diplomats (e.g. Sir), members of the Senate (Senator) or Congress (Congressman/Congresswoman), judges, medical doctors and others with a doctorate, military officers (e.g. General, Colonel), professors, priests and other religious ministers (e.g. Father, Rabbi, Reverend). If you’re invited to dinner, it’s customary to take along a small present, e.g. flowers, a plant, chocolates or a bottle of wine (but nothing extravagant or ostentatious). But choosing flowers you should remember that American people pay attention to the meaning of flowers. For example carnations are associated with bad luck, chrysanthemums are for cemeteries and roses signify love. Guests are normally expected to be punctual with the exception of certain society parties, when late arrival is de rigueur (provided you don’t arrive after the celebrity guest). It’s usual to arrive half an hour to an hour after the official start of a dance. Invitations to cocktail parties or receptions may state 5pm to 7pm, in which case you may arrive at any time between these hours. Dinner invitations are often phrased as 8pm for 8.30pm. This means you should arrive at 8pm for drinks and dinner will be served at 8.30pm. Anyone who arrives late for dinner or doesn’t turn up at all, should expect to be excluded from future guest lists. On the other hand, you must never arrive early. The custom of not taking off the shoes is peculiar to Americans. That is why don’t think of whether you should take off your shoes or not. If it is necessary the host will warn you about it himself. When watching American films I always wondered why Americans did not take off their footwear. The matter turns out to be that there is no much dirty and dust in American streets. Some people who were in America say that it is possible to sit on some pavements and not to make oneself dirty. One more reason explaining this custom is that majority of Americans prefer driving but not going of foot. That is why they are not afraid of dirtying their houses. Some families say grace before meals, so follow your host’s example before tucking in. Table manners are more relaxed in the U.S. than in many other countries. The fork is held in the right hand and is used for eating. The knife is used to cut something. To use the knife, the fork is switched to the left hand. To continue eating, the fork is switched back to the right hand. Don’t overstay your welcome. This becomes obvious when your host starts looking at his watch, talking about his early start the next day. The custom which is also typical for the USA is tipping. Most Americans are shocked by anyone who doesn’t tip or who tips too little. The one you will encounter most often is at restaurants. American restaurants do not add a service charge to the bill. Therefore it is expected that the customer will leave a tip for the server. Common practice is to leave a tip that is equal to 15% of the total bill for acceptable service, and about 20% for superior service. If the service was unusually poor, then you could leave a smaller tip, about 10%. Other professions where tipping is expected include hairdressers, taxi drivers, hotel porters, parking valets, and bartenders. The general rule is to tip approximately 15% of the bill. In situations where there is no bill the tip may range from $1 to $5, depending on the type of establishment and on how good the service was. The custom of tipping came to America from Great Britain. In the 18th century in Great Britain the boxes with the inscription T.I.P.S. which was meant To Insure Prompt Service were on the tables during having tea. Then this term came to America. Baby showers have been a tradition in the US for a long time now, and are growing in popularity here, too. What better excuse is there for getting a group of friends together than to celebrate a new life? Plus, the mum-to-be get lots of great presents for her and her baby, result! The only person who shouldn’t arrange a baby shower is the mum-to-be. The whole event should be great fun and completely stress-free for her. Friends, family or work colleagues are the usual organizers. You could either keep it as a surprise for the mum-to-be, or tell her what you are planning. Baby showers usually have some sort of baby theme to get everyone in the mood. Popular themes include: Teddy bear’s tea party. Get hold of as many teddies as you can and make sure each guest brings one, too! As presents, they could bring teddy bear-related books. The cake could be in the shape of a teddy bear. You get the general idea! Nursery rhymes. Arrange toys linked to nursery rhymes around the room , such as shoes (There was an old lady), a spider (Little Miss Muffet), a bucket (Jack & Jill’s pail), and toy boats (Row row row your boat). Ask guests if they can count how many rhymes are represented. Books. Ask each guest to bring a book that meant something to them as a child. It’s a great way for mum to start up her child’s library. For decoration, everyone could also bring books to arrange around the room. The cake could be in the shape of a fairytale book. One more tradition connected with babies is to give a baby a birthstone. The Tradition of Birthstones goes back further than written history. People wear jewelry containing stones designated for their Birth Month. In the USA there are a lot of traditions connecting with wedding. It is known that before marriage engagement takes place. As a rule a man invite a woman to the restaurant to make her a proposal. Engagement ring obligatory should have a brilliant. The diamond engagement ring originated with King Maximillian who presented Mary of Burgundy with a diamond ring in 1477 as a token of his love. And the ring is presented unexpectedly. It may found in the glass of champagne by the woman or in the bud of the rose. To my mind this tradition is very romantic. The tradition of a Bachelor Party which is held for the Groom and usually sponsored by The Best Man the night before the Wedding and a Bridal Shower which is usually sponsored by The Bride’s Maid is very popular in the USA. By the way the number of bridesmaids in America amount from two to twenty. The tradition of bridesmaids dressing the same as each other and in similar style to the bride comes from ancient days when it was believed that evil spirits have a more difficult time distinguishing which one is the bride and putting a hex on her. The tradition of a Wedding Rehearsal Dinner also takes place in America. It is usually celebrated between the immediate families of spouses in the late afternoon the day before the wedding. The Groom’s Family traditionally provides for this celebration. The Wedding Ceremony is most often performed as part of a religious ceremony each with its own specific customs and traditions. On the day of the wedding the Groom does not see the Bride until the actual ceremony. As Custom would have it from Victorian Times: the Bride wears Something Old, Something New, Something Borrowed, Something Blue, and a Sixpence in her shoe. The bride and groom exchange their rings to mark the permanent commitment of the new spouses to each other. The rings should be gold. According to history gold rings signified a financial sacrifice on the part of the prospective husband. Ring finger is the fourth ringer which is considered to be connected directly to the heart by a route that was called â€Å"the vein of love.† In the USA tradition of engraving of wedding rings is popular. The kiss on weddings dates back to the earliest days of civilization in the Middle East. A kiss was used as the formal seal to agreements, contracts, etc. In Ancient Rome a kiss was still being used as the legal bold to seal contracts. Hence the obvious use of the custom at the end of the wedding ceremony to â€Å"seal† the marriage vows. After the wedding ceremony newlyweds are covered with rice which is used as a symbol of fertility and as a wish for a â€Å"full pantry†. A Wedding Reception is usually held after the ceremony for all family and friends to celebrate. The Bride’s Family usually provides for this celebration. Traditionally the groom’s flower, worn on his lapel, usually matches one of the flowers in his bride’s bouquet. This tradition goes back to medieval times when knights wore the colors of their lady in tournaments. All of us know the tradition of throwing bridal bouquet and garter. The history of this tradition is very interesting I believe. In parts of Europe during the 14th contrary, having a piece of the bride’s clothing was thought to bring good luck. Guests would literally destroy the brides dress by ripping off pieces of fabric. In order to prevent this, brides began throwing their bouquets to the unwed girls. And grooms began to throw garter to unmarried men. One more wedding tradition is connected with CARRYING THE BRIDE OVER THE THRESHOLD Traditionally, the bride had to enter her new home the first time through the front door. If she tripped or stumbled while entering it was considered to be very bad luck. And the groom carried her over the threshold les she should stumble. Hence the tradition of the groom carrying the bride over the threshold. They bring us all together, no matter where we are. We can all relate to them and understand each other because we all use them. It is also a great connection for family and friends. There are traditions that are upheld for hundreds of years that are so important in our hearts. It links and connects us to past members of our family and our world whom we may never have gotten the chance to meet. They teach us about ourselves, our families, and the world around us. We can learn our history, why this tradition was started and what it signifies when we follow it today. They can work as the glue that holds us together. They are our culture, our heritage; they are us.